TY - JOUR
T1 - Antibiotic Prescribing in Outpatient Children
T2 - A Cohort From a Clinical Data Warehouse
AU - Grammatico-Guillon, Leslie
AU - Shea, Kimberly
AU - Jafarzadeh, S. Reza
AU - Camelo, Ingrid
AU - Maakaroun-Vermesse, Zoha
AU - Figueira, Marisol
AU - Adams, William G.
AU - Pelton, Steve
N1 - Publisher Copyright:
© The Author(s) 2019.
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Aim. To characterize antibiotic (ab) prescriptions in children. Methods. Evaluation of outpatient ab prescriptions in a 3-year cohort of children in primary care using a data warehouse (Massachusetts Health Disparities Repository) by comorbid conditions, demographics, and clinical indication. Results. A total of 15 208 children with nearly 120 000 outpatient visits were included. About one third had a comorbid condition (most commonly asthma). Among the 30 000 ab prescriptions, first-line penicillins and macrolides represented the most frequent ab (70%), followed by cephalosporins (16%). Comorbid children had 54.3 ab prescriptions/100 child-years versus 38.8 in children without comorbidity; ab prescription was higher in urinary tract infections (>60% of episodes), otitis, lower respiratory tract infections (>50%), especially in comorbid children and children under 2 year old. Ab prescriptions were significantly associated with younger age, emergency room visit, comorbid children, and acute infections. Discussion. A clinical data warehouse could help in designing appropriate antimicrobial stewardship programs and represent a potential assessment tool.
AB - Aim. To characterize antibiotic (ab) prescriptions in children. Methods. Evaluation of outpatient ab prescriptions in a 3-year cohort of children in primary care using a data warehouse (Massachusetts Health Disparities Repository) by comorbid conditions, demographics, and clinical indication. Results. A total of 15 208 children with nearly 120 000 outpatient visits were included. About one third had a comorbid condition (most commonly asthma). Among the 30 000 ab prescriptions, first-line penicillins and macrolides represented the most frequent ab (70%), followed by cephalosporins (16%). Comorbid children had 54.3 ab prescriptions/100 child-years versus 38.8 in children without comorbidity; ab prescription was higher in urinary tract infections (>60% of episodes), otitis, lower respiratory tract infections (>50%), especially in comorbid children and children under 2 year old. Ab prescriptions were significantly associated with younger age, emergency room visit, comorbid children, and acute infections. Discussion. A clinical data warehouse could help in designing appropriate antimicrobial stewardship programs and represent a potential assessment tool.
KW - antibiotherapy
KW - data warehouse
KW - pediatric
KW - primary care
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U2 - 10.1177/0009922819834278
DO - 10.1177/0009922819834278
M3 - Article
C2 - 30884973
AN - SCOPUS:85063339093
SN - 0009-9228
VL - 58
SP - 681
EP - 690
JO - Clinical Pediatrics
JF - Clinical Pediatrics
IS - 6
ER -